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Jagged lines in mask pressure that leads to obstructive event?
#1
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Jagged lines in mask pressure that leads to obstructive event?
Hey all,
I'm a new CPAP and OSCAR user here I've used my machine for 3 nights and it's been great but I need a few fixes plz

I've attached my graphs, any help would be appreciated!

I've noticed in my "mask pressure" graph that I get these jagged lines throughout the night that will consistently give me obstructive events (sometimes they're hypopnea or clear airway). The machine reacts to this and increases mask pressure right after, but i was hoping it didn't have to get to that stage lol. These jagged lines seem to last 7-10 seconds and then without fail, an event will occur and my inspiration time will go up.

Is this a machine error? Do I need to change some settings? EPR was on 3. Autoset 10 on Soft mode. CPAP was auto.

Thanks!

   
   

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#2
RE: Jagged lines in mask pressure that leads to obstructive event?
The "jagged lines" are ResMed's Forced Oscillation Technique (FOT) where it is trying to determine whether the lack of air flow is being caused by an obstructive apnea or a clear airway (aka central apnea) condition. They are not causing the apnea but instead the means by which the CPAP machine is trying to determine what kind of apnea it is.

If you would like advice on your therapy settings, please post a screen shot of the Daily page. If you have your sleep study results, please post them also after redacting any personal identifying information. We really need to see the entire day to develop an understanding about what is happening.
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#3
RE: Jagged lines in mask pressure that leads to obstructive event?
(09-04-2021, 08:58 PM)GuyScharf Wrote: The "jagged lines" are ResMed's Forced Oscillation Technique (FOT) where it is trying to determine whether the lack of air flow is being caused by an obstructive apnea or a clear airway (aka central apnea) condition. They are not causing the apnea but instead the means by which the CPAP machine is trying to determine what kind of apnea it is.

If you would like advice on your therapy settings, please post a screen shot of the Daily page. If you have your sleep study results, please post them also after redacting any personal identifying information. We really need to see the entire day to develop an understanding about what is happening.

Ah i see thanks for that, I'm learning lots. I have things attached that may help more! Tyvm


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#4
RE: Jagged lines in mask pressure that leads to obstructive event?
Obviously your main events were centrals. Your machine will not treat them it takes a special pap machine (and much more expensive). But we can try to limit them.

To do that we would need to narrow the difference between the min and max numbers and turn off the EPR if you have it on.

So the settings I would try are:
Min 9
Max 12
EPR 0

That should help cut them down. Give it a try for one night and post tomorrow.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#5
RE: Jagged lines in mask pressure that leads to obstructive event?
(09-04-2021, 09:59 PM)staceyburke Wrote: Obviously your main events were centrals.  Your machine will not treat them it takes a special pap machine (and much more expensive). But we can try to limit them.

To do that we would need to narrow the difference between the min and max numbers and turn off the EPR if you have it on.

So the settings I would try are:
Min 9
Max 12
EPR 0

That should help cut them down. Give it a try for one night and post tomorrow.

Hmmm interesting. The first two nights showed much different results though - centrals weren't a huge problem. I've attached screenshots of them.
My first two nights were rougher in terms of comfort, but last night (with centrals being my main) definitely felt more adjusted.  Could it be that because my body is starting to get used to the machine, my CNS is a bit confused? 

What would you recommend for "soft" or normal setting? But thank you I will try those settings out!


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#6
RE: Jagged lines in mask pressure that leads to obstructive event?
Your Diagnostic Sleep Test shows roughly equal Obstructive and Central ( The differences are IMHO insignificant and will (should) not impact treatment). This suggests the Centrals are idiopathic or of unknown cause.

Setting min =4 is a copout and IMHO incorrect anyway.

Set Min Pressure = 7, this is applicable to adults, (4 is often thought of as a pediatric setting) This allows EPR to act throughout all of its settings providing a more even breathing throughout the night. This I think is the cause of the discomfort you are feeling.

EPR is set to 3 Fulltime, Because you have at times (more on this later) significant central apnea we want to try to minimize them. In your case I'm not at all sure this will help but Set EPR=1 Fulltime. With some types of CA, I don't think yours but hope I'm wrong, this will significantly improve/reduce the central apnea. Stacy said set EPR = 0 and we may get there but try EPR=1 first.

Central Apnea has a characteristic that we lovingly call Consistently Inconsistent. This means that CA can bounce all around from good to very bad for no apparent reason. This means we need to see several days before we can be sure changes are working on the Centrals.

Finally, the ResMed AutoSet is an excellent machine, actually among the best, BUT NOT FOR CENTRAL APNEA. If your doctor is any good he is expecting you to fail with this machine (CPAP), then FAIL on a BiLevel without backup (VAuto), Then Fail on a BiLevel with backup (Timed Breathing), finally ending on an ASV machine and succeeding. This is likely your future.
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#7
RE: Jagged lines in mask pressure that leads to obstructive event?
This has been wonderfully helpful for a newbie like me. Thank you everyone, I'll post updates!
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